The validity of hysterosalpingography versus laparoscopy in the diagnosis of tubal factors in the infertile women in mosul

Objective: To define the tubal factors as a cause of female infertility and compare between HSG and laparoscopy as valid diagnosis for tubal disease. Study setting: Infertility centre at Al-Batool Teaching Hospital in Mosul. Design: Descriptive case serial study. Study Participant: Three hundred infertile women attending Al-Batool infertility centre in Mosul. Intervention: (300) infertile women enrolled for this study from November 2006 to May 2008 (1.5 years), their age were between 17-43 years old. All the patients were evaluated by full history, medical and social, complete physical examination and investigation that include tests for ovulation, hormonal assay, Hysterosalpingography to detect tubal patency and laparoscopy once indicated. Both partners are seen at the initial visit. Main measures: evaluation of tubal patency, associated pelvic and peritoneal disease and to compare the validity of HSG versus laparoscopy in the diagnosis of tubal factor in the infertile women. Results: this study revealed that tubal factor was accounted for to 28.67% of female infertility, mainly in primary infertility in 72% of patients for a duration for more than 3 years of infertility. The site of obstruction in the right tube in 37% in compare to left tube in 23% of patients and distal more than proximal tubal obstruction in 59.31% and 40.69% respectively. The accuracy of HSG versus laparoscopy in the diagnosis of tubal factors in female infertility was in a sensitivity of 71.79% and a specificity of 95.53%. Conclusion: When comparing HSG and laparoscopy, laparoscopy should be considered as more perfect in the diagnosis of tubal pathology in the infertile women.